Why don’t more nearsighted Chinese kids wear glasses?

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It’s estimated that up to 60 percent of school-age children in rural China need glasses to see clearly, but most either don’t have them or don’t wear them if they do. A new study suggests that misinformation about wearing glasses and the inconvenience of getting them—not cost—may be at least partly to blame.

Children with myopia (also called nearsightedness or shortsightedness) have trouble seeing objects clearly at a distance, and for some, the condition progresses quickly.

“People of Chinese origin have been shown to have some of the highest rates of shortsightedness in the world,” Abhishek Sharma, of Oxford University in the UK and an author on the new study, noted in an email to Reuters Health. 

In a previous study, researchers found that two-thirds of a group of nearly 700 rural Chinese children identified through a screening program as needing glasses failed to get them. The large number of rural children needing glasses rivaled what was seen in densely packed urban areas of China and was a “surprise,” noted Sharma, who is currently studying ophthalmology at the Royal Victorian Eye & Ear Hospital in Melbourne, Australia.

To find out why rural children aren’t getting the glasses they need, Sharma and colleagues held a series of focus groups at three schools in 2007 and 2008. They explored attitudes about a range of issues surrounding vision health with 28 teenagers, their parents and 21 of the teen’s teachers.

Although all 28 teenagers had been diagnosed with myopia, only 10 reported wearing glasses, the researchers report in the Archives of Ophthalmology. None of the parents wore glasses and some of the randomly selected teachers did.

The largest impediment to getting kids glasses wasn’t what might have been expected—namely, prohibitive costs (about $15 a pair, according to Sharma) or feeling that glasses were ugly. “Too expensive” was not a common reason cited by parents and the teens didn’t seem overly concerned with the appearance of glasses, the investigators note.

Rather, misinformation appeared to rule the day and removed any sense of urgency to act, especially when coupled with the “inconvenience” of taking children for the eye exam cited by the parents, who were largely farmers.

For instance, even though studies have suggested that wearing glasses does not worsen eyesight, parents, teachers and the children, themselves, worried that wearing glasses could weaken the eyes or change their shape.

Some parents thought they could prevent vision problems with nutritional supplements, eye drops, monitoring their children’s posture while reading, limiting close-up work, and encouraging eye exercises.

Parents, children and teachers all agreed that not wearing glasses when you need them could lead to injuries, lower grades and fewer career choices, but misinformation about the effects of myopia on vision, their child’s own diagnosis, misplaced concern that glasses can harm the eyes, and faith that unproven remedies might slow the process, erected barriers to “effective action,” the researchers say.

Sharma believes doing nothing to address widespread uncorrected vision problems could lead to social and political unrest down the road.

“The main concern is that there may be a significant portion of the current generation of rural population ‘left behind’ due to the lack of education and poor access to high quality glasses,” Sharma said.

SOURCE: Archives of Ophthalmology, June 2010.

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